Funktionelle Bildgebung mit [F-18]FDG bei Kopf-Hals-Tumoren: Korrelation mit morphologischen Methoden

Zusammenfassung

In der Diagnostik von Kopf-Hals-Tumoren ist die FDG-PET nach derzeitigem Stand der Literatur und nach eigenen Erfahrungen der CT in der Diagnostik der Primär-/Rezidivtumoren und in der Diagnostik zervikaler Lymphknotenmetastsasen überlegen. Dies gilt auch für die Diagnostik von Fernmetastasen oder die Detektion von Zweittumoren, die bei typischem Patientengut überhäufig auftreten. Für die exakte Interpretation der in der PET erhobenen Befunde ist jedoch die Korrelation mit der morphologischen Bildgebung sinnvoll und notwendig. Die Bildkorrelation verbindet hierbei die Vorteile der funktionellen und der morphologischen Methodik ohne wesentlichen zusätzlichen Aufwand, da PET und CT im Rahmen des Stagings durchgeführt werden. Diese Methodik erlaubt eine bessere anatomische Zuordnung der PET Befunde und eine bessere Differenzierung der im CT auffälligen Befunde. In einem klinischen Umfeld sollte die Bildkorrelation zur Verbesserung der diagnostischen Aussagekraft routinemäßig bei Tumoren der Kopf-Hals-Region durchgeführt werden. Auf eine exakte Fusion der Datensätze kann in den meisten Fällen verzichtet werden; diese bleibt problematischen Situationen mit unklaren anatomischen Verhältnissen vorbehalten.

Abstract

In the diagnosis of tumors of the head and neck FDG-PET is according to the literature superior to CT in terms of diagnosing primary and recurrent tumors as well as cervical lymph node spread. FDG-PET is also better in detecting distant metastatic disease and in screening for secondary malignant lesion which are rather common in this patient group. However, correlation of the findings with morphological methods such as CT is crucial. Image correlation combines the advantages inherent to both, functional and morphological methods, without sacrificing too much time, since both methods are included in most staging protocols. This approach allows for better anatomical correlation of PET findings and an improved differentiation of the CT results. In a clinical setting image correlation should routinely be performed to increase diagnostic accuracy and efficiency. A very exact fusion of both data sets, however, is in most circumstances dispensable and may only be necessary in exceedingly complex anatomical situations.

Schlüsselwörter

PET - [F-18]FDG - CT - Kopf-Hals-Tumoren

Key words

PET - [F-18]FDG - CT - head and neck tumors

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